In this episode of Former Fed Friday, host Shelley McGuire and co-host Hunter Gros sit down with Ariel Winter, founder of ABW Health Strategies and former longtime federal leader with nearly three decades in government, including roles at OMB, HHS, MedPAC, and CMS. Ariel shares his remarkable journey from intern to senior Medicare policy expert—offering a rare insider’s view of how federal health programs are shaped, funded, and implemented. He explains what it’s really like to translate congressional intent into real-world healthcare policy and how his new consulting firm helps bridge the gap between government and industry. The conversation explores lessons learned across the legislative and executive branches, the evolution of healthcare policy over 30 years, and the constant challenge of balancing cost, access, and innovation. Plus, Ariel reveals his favorite vacation memory—walking on a glacier in Iceland—and what’s next for him post-CMS. Whether you’re a policy wonk, a healthcare contractor, or just curious how Medicare really works behind the scenes, this episode delivers deep insights with personal warmth and perspective. To connect with Ariel, visit his LinkedIn profile here.